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Dallas County Health and Human Services - Environmental t li Di i Oi V il 1/
Retail Food Establishment Inspection Report
WY RM 607 DALLAS, TX 75207 214-819-2115 FAX: 214-819-2
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Time in:.- ..- Time out: License/Permit # Est. Type Risk Category Page 1 of L ,L)
1).th:
Purpos of Inspection:
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I -Compliance 11-1 2-Routine =1 3-Field Investigation 4-Visit 5-Other TOTAL/SCORE
Establishme t Na e.• Contact/Owner Name: :k Number of Repeat Violations: ,.
C.% ‘,.. I
I Number of Violations COS:
Phy cal
LA Or'l i- CI 1 II LL. - CittCt• 1 \ ‘'t
ty:
t • Z p de: Phonc: ,......, ____‹-
C / A. 7MLL.)
Follow-up: Yes
No (circle one)
Compliance Status: Out = not in compliance IN -- in compliance N = not observed NA = not applicable COS = corrected on site R = repeat vto
Mark the appropriate points in the OUT box for each numbered item Mark '1' a c c mark in appropriate box for IN, NO, NA, COS Mark an asterisk ' * ' in appropriate box for R
Priority Items (3 Points) violations Rewire Immediate Corrective Action not to exceed 3 days
Compliance Status r
Compliance Status ,1
O I N N C
0 1 N N
Time and Temperature for Food Safety
U N OAO
U N 0 0 , Employee Health
T s (F = degrees Fahrenheit) T
2. Proper Cold Holding temperature(41°F/ 45°F) 13. Proper use of restriction and exclusion; No discharge from knowledge, responsibilities, and reporting 1. Proper cooling time and temperature
12. Management, food employees and conditional employees;
eyes, nose, and mouth
, 3. Proper Hot Holding temperature( 135°F)
Preventing Contamination by Hands
„........4 4. Proper cooking time and temperature I: /14. Hands cleaned and properly washed/ Gloves used properly
• 5. Proper reheating procedure for hot holding (165°F in 2 V 15. No bare hand contact with ready to eat foods or approved
3 Hours)
al ate method properly followed (APPROVED Y N )
6. Time as a Public Health Control: procedures & records Highly Susceptible Populations
Approved Source
16. Pasteurized foods used; prohibited food not offered
Pasteurized eggs used when required
7. Food and ice obtained from approved source: Food in
t. good condition, safe, and unadulterated; parasite
Chemicals
destruction
8. Food Received at proper temperature 17. Food additives; approved and properly stored; Washing Fruits
& Vegetables
Protection from Contamination 18. Toxic substances properly identified, stored and used
-----(/ 9. Food Separated & protected, prevented during food
Water/ Plumbing
preparation, storage, display, and tasting
L 10. Food contact surfaces and Retumables ; Cleaned and 19. Water from approved source; Plumbing installed; proper
,,,Sanitized at ppm/tem erature backflow device
11. Proper disposition of returned, previously served or 20. Approved Sewage/Wastewater Disposal System, proper
ta , reconditioned
disposal
Priority Foundation Items (2 Po nts) violations Require Corrective Action within 10 days
O I N N C
R 0 1 N N C
U N 0 A 0 Demonstration of Knowledge/ Personnel U N 0 A 0 Food Temperature Control/ Identification
T S
T S i
,,,,,,,/ 2anl d. Ppeerrsfoonrmindcutte present, demonstration dFeomodonmstarantaigoenrok m) knowledge, 27. Proper cooling method used; Equipment Adequate to
Maintain Product Temperature
J 22 Food Handler/ no unauthorized persons/ personnel 28. Proper Date Marking and disposition
Safe Water, Recordkeeping and Food Package / 29. Thermometers provided, accurate, and calibrated; Chemical/
Labeling
Thermal te tri s
23. Hot and Cold Water available; adequate pressure, safe equiremen Prerequisite for Operation
24. Required records available (shellstock tags; parasite
destruction): Packaged Food labeled
30. Fo h nulnitI/V g&i,Val inii 1 i +___
Conformance with Approved Procedures Utensils, Equ pment, rid 'ending'
2 eiimpliance with Variance, Specialized Process, and 31. Adequate handwashing facilities: Accessible and properly
ACCP plan; Variance obtained for specialized
processing methods; manufacturer instructions
supplied, used
Consumer Advisory
32. Food and Non-food Contact surfaces cleanable, properly
vi) designed, constructed, and used
(.7~6. Posting of Consumer Advisories; raw or under cooked
._
33. Warewashing Facilities; installed, maintained, used/
foods (Disclosure/ReminderBufTet
Service sink or curb cleaning facility provided
Core Items (1 Point) Violations Require Corrective Action Not to Exceed 90 Dap or Next Inspection , Whichever Conies First
0 I N N C
R 0 1 N N
U N O A 0 Prevention of Food Contamination U N 0 A 0 Food Identification
T S
T S
,,t
36. Wiping Cloths; properly used and stored
42. Non-Food Contact surfaces clean
34. No Evidence of Insect contamination, rodent/other
animals
35. Personal Cleanliness/eating, drinking or tobacco use
4 I .Original container labeling (Bulk Food)
Physical Facilities
..,":"..,/R 37. Environmental contamination
43. Adequate ventilation and lighting; designated areas used
38. Approved thawing method
44. Garbage and Refuse properly disposed; facilities maintained
Proper Use of Utensils • 45. Physical facilities installed, maintained, and clean
39. Utensils, equipment, & linens; properly used, stored, 46. Toilet Facilities; properly constructed, supplied, and clean
dried. & handled/ in use utensils; properly used
tr 40. Single-service & single-use articles; properly stored 47. Other Violations
and used
(signature) /1/4 : /eL (It: c lit C ai Print. gel ffi 6c,,k(..x Received by: 1
Title: Person In Charge/ Owner
......., I () 1 1 ;'70 1 h•11144YAi i I r ril-1-acted bi4"
Business Email:
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